The importance of ethnicity as a risk factor
for STDs and sexual behaviour among heterosexuals
[see comments]

Municipal Health Service of Amsterdam,
Department of Public Health,
The Netherlands.

OBJECTIVES: To study risk factors for sexually
transmitted diseases (STDs) and sexual behaviour.
Especially to assess whether there is a higher risk of
being infected with STDs among ethnic minorities, and if so
for what reasons.

SETTING: STD-clinic of the Municipal Health
Service of Amsterdam, the Netherlands.

SUBJECTS: Cross-sectional study of heterosexuals
(255 men and 343 women) with multiple sexual partners, who
participated between October 1987 and January 1990.

RESULTS: Besides STD-related complaints,
ethnicity was an important independent predictor of one or
more diagnosed genital STDs. STD-prevalence was higher
among men born in Turkey (47%, OR = 3.4) and men born in
Surinam (36%, OR = 2.1), compared with Dutch men (21%).
While Turkish men had mainly riskful sexual behaviour with
prostitutes, Surinam men had more often riskful sexual
contact with private partners. Among women, STD prevalence
was higher among West-European (38%, OR = 2.3) and
Latin-American women (30%, OR = 1.6), compared with Dutch
women (21%). Latin American women had more often riskful
sexual contact with clients; sexual behaviour of
West-European women was riskful with both clients and
private partners.

CONCLUSIONS: Prevention activities should be
directed at specific sexual and ethnic groups, sources of
information should be carefully selected, and some groups
should be addressed differently with regard to language but
to content as well.

[CIRP Note: This study is significant
because Dutch men are usually non-circumcised intact males,
but immigrant men from Turkey and Surinam are Muslims, who
are usually circumcised for religious reasons. This study
confirms the findings of Laumann et al. that
circumcised men tend to engage in more risky sexual
behavior and have a higher incidence of STD.]